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Volume 3, Number 3—September 1997
Perspective

DDT, Global Strategies, and a Malaria Control Crisis in South America

Donald R. RobertsComments to Author , Larry L. Laughlin, Paul Hsheih, and Llewellyn J. Legters
Author affiliations: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

Main Article

Figure 8

Standardized annual parasite indexes for 21 countries of the Americas, 1959-1995. Major changes in global malaria control strategies are depicted with arrows along the x axis (WHA 31.45 for 1979; WHA 38.24 for 1985; and the Global Malaria Control Strategy for 1992). Statistical data were derived from reports of the Pan American Health Organization (2-4). Block A represents a period of malaria control by spraying adequate numbers of houses with insecticide residues (primarily DDT). Block B repres

Figure 8. Standardized annual parasite indexes for 21 countries of the Americas, 1959-1995. Major changes in global malaria control strategies are depicted with arrows along the x axis (WHA 31.45 for 1979; WHA 38.24 for 1985; and the Global Malaria Control Strategy for 1992). Statistical data were derived from reports of the Pan American Health Organization (2-4). Block A represents a period of malaria control by spraying adequate numbers of houses with insecticide residues (primarily DDT). Block B represents a period of increasing malaria as the house-spray rates declined below effective levels. Open circles represent house-spray rates and solid squares represent standardized annual parasite indexes.

Main Article

References
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1This percentage was obtained by adding the number of slides from passive case detection reports and from voluntary collaborators and then dividing the sum by the number of slides acquired through active case detection.

2Statistics drawn from a U.S. Agency for International Development review in 1973-1974 of the malaria eradication program in Brazil and based on regions that were in the attack phase. There was greater reliance on active and epidemiologic surveys in such areas than in areas of consolidation or maintenance. Therefore, the overall percentage of slides derived from passive case detection was undoubtedly higher than 35%.

3The Commission for Environmental Cooperation (CEC) is a North American environment commission established by a North American Free Trade Agreement side agreement. The CEC draft agreement entitled "North American Regional Action Plan on DDT, Task Force on DDT and Chlordane," dated October 10, 1996, calls for the elimination, distribution, and use of DDT for malaria control in Mexico in 10 years.

4Recommended weekly treatments of 0.9-1.36 kg (2-3 pounds) of DDT per 0.004 km2 (1 acre) of cotton. Using a 7-week period and a treatment of 1.13 kg (2.5 pounds) per 0.004 km2, 340 kg (1.750 pounds) of DDT is required for 0.4 km2 (100 acres) of cotton.

5World Health Assembly document A31/19, 1978.

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